Polymorphism of FPN1 Gene Promoter -1355 G/C as A Risk Factor of Iron Deficiency Anemia in Pregnant Women in Indonesia

Nor Istiqomah, Sarah Safira Umarghanies, Arta Farmawati, Ahmad Hamim Sadewa, Yuliana Heri Soesilo, Kusumadewi Eka Damayanti, Dono Indarto


According to WHO, the prevalence of anemia in pregnancy in Indonesia is 44.3%, it is higher than the worldwide prevalence (41.8%). Iron deficiency is a leading cause of anemia during pregnancy. Ferroportin (FPN1) is an iron exporter protein which is responsible on absorbing and releasing iron in order to reproduce new erythocytes. The variant of FPN1-1355 G/C in promoter region enhances overexpression of ferroportin and iron export, which are causing elevated cellular iron needs and thus leading to overexpression of soluble transferrin receptor (sTfR) while decreasing hemoglobin (Hb) level and erythrocyte indices. As the manifestation, iron deficiency anemia (IDA) occurs. This research was a case and control study aimed to analyze the frequency of FPN1-1355 G/C polymorphism as a risk factor of IDA in pregnant women in Indonesia. Blood samples were taken from 26 pregnant women with anemia and 48 without anemia. FPN1-1355 G/C polymorphism were determined by PCR-RFLP method while sTfR and ferritin level were measured by ELISA. Hemoglobin, erythocyte indices, and sTfR level were compared among genotype group, then analyzed by independent t-test and one way ANOVA. Pearson test was conducted to analyze correlation between level of hemoglobin and ferritin in pregnant women (p<0.05). As the results, the frequency of FPN1-1355 G/C polymorphism in anemic pregnant women with IDA and non IDA were 100% and 95.2%, respectively (p=1.000; OR=0.800; 95%CI= 0.658-0.973). The mean of Hb level and erythrocyte indices in subject carrying C allele were lower than subjects carrying only G allele, although Hb level was not significantly different (p>0.05). The sTfR level in subject carrying C allele was higher than subjects carrying only G allele (p<0.05). As a conclusion, FPN1 gene promoter -1355 G/C polymorphism was not a risk factor for anemia, but it was a risk factor for IDA in pregnant women. 

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